Breast Augmentation, or Breast Enlargement surgery, is a procedure which involves the placing of an implant immediately behind the breast tissue or, if necessary, underneath the muscle that lies beneath the breast. The inserted breast implant pushes and projects the natural breast tissue forward, giving a fuller and larger breast appearance.
The procedure is carried out under local anaesthetic with sedation and the implant is usually inserted through a short, inconspicuous incision that runs in the natural fold under the breast. The Westbourne Centre is one of only a handful of clinics in the UK to perform Breast Augmentation under local anaesthesia with sedation – a procedure pioneered by the centre’s own consultant plastic surgeon's Fazel Fatah and Hiroshi Nishikawa.
The Westbourne Centre has the policy that all our patients deserve the same high standard of treatment and quality of surgery at all times. All patients will benefit from a completely consultant delivered experience and quality post-operative aftercare.
What are Breast Implants?
There are two types of breast implants available: silicone gel-filled or saline-filled; there are advantages and disadvantages to both types and our surgeons will be able to explain which would be the best choice for you. Silicone is a material widely used in implantable medical devices, and the implants have an outer shell constructed from several layers of elastic silicone material. Saline implants consist of a silicone elastomer shell with an integrated valve. During surgery the implants are filled with a sterile saline solution to the desired size.
Selecting an implant Breast shape and size should be an important focus of discussion with our surgeons when talking about breast augmentation. You will want to discuss whether to use round or anatomical shaped implants and review the many choices of size and weight available. Our surgeons will advise you on your specific concerns and the likely aesthetic improvement attainable. It may be difficult to visualize your ultimate breast shape and size before surgery, and it is worthwhile to not only consider size but also the width of your chest and desired projection. A wider implant may provide more cleavage, but less fullness of the breast. A higher profile implant will provide more projection and fullness but have less width and cleavage.
Your body's size and characteristics, along with your desire for a specific shape and size, will normally decide what is possible. You should be aware that after implant surgery one woman's breasts will be different than another’s, even though the same implant size and shape were used. Also be aware that each woman's body is different and before and after photos of women who have had breast implant surgery, often in the media, are not likely to apply to you.
Position - Implants may be placed either beneath the breast tissue or on top of the pectoralis muscle (subglandular) or partially beneath the pectoralis major muscle (submuscular). There are advantages and disadvantages of each placement and your surgeon will discuss both and recommend the best choice for you. Generally, placement of an implant beneath the muscle gives an extra layer of muscle coverage and may be the choice for patients with minimal breast tissue. Our surgeons can perform both options under local anaesthetic with sedation.
Incisions - Breast implants can be inserted through an incision either in the infra-mammary fold (crease under the breast), around the areola (around the nipple), or under the axilla (armpit). Depending on the implant size this incision may vary from 3-6cm in length. The incision in the infra-mammary fold is often hidden by the natural droop of the breast and is not seen unless an observer is looking up under the breast. The incision around the areola is hidden to some extent by the colour change at the edge of the nipple. The incision under the axilla would not be seen unless the arm is raised.
Recovery - during the Breast Augmentation procedure, patients are given a local anaesthetic and sedation, but are not completely unconscious. The recovery time is much faster than compared with the same procedure using a general anaesthetic, which usually involves an overnight stay in hospital. This is one of the benefits of all breast augmentation and cosmetic surgery procedures performed at The Westbourne Centre, our patients will be able to recover in the comfort of their own home.
Time off work is an individual matter, and variable, but can range from 5 days to two weeks. You will be fully informed about the implications of having breast augmentation and any possible short or long-term complications. You will need to discuss with your surgeon which procedure is best for you. The final decision to have surgery is, as always, your own personal choice.
Pregnancy and Breast Implants - The presence of a breast implant will have no effect on your ability to become pregnant, deliver a baby, or even breastfeed. Breast implants have not been shown to have an effect on children or future offspring.
Breast Feeding - Breast implant surgery should not prevent you from following any desire you may have to breast feed. Be aware that the surgical approach used for implant placement may influence breast feeding as the option of placing the scar around the nipple area could, theoretically, interfere with the breast ducts. While this is uncommon and still theoretical, discuss options with our surgeons and be sure to indicate any interest you may have in breast feeding in the future.
We would like you to know that The Westbourne Centre has never used PIP implants; we only use high quality medical grade breast implants from long established reputable manufacturers. If you have had a Breast Augmentation and you are not sure what implants you have, contact the clinic, hospital or surgeon who carried out your operation and ask about the type of implants you have. You are entitled to access the precise information about this.
If you know that you have had PIP implants and have symptoms such as pain, swellings, tenderness and hardening of the breast(s) or enlarged lymph nodes with hard lumps forming in your underarm(s) you need to seek advice as early as possible. We advise that you contact the clinic or the hospital where you originally had your surgery, however if you have no success, contact your GP to refer you to a qualified NHS plastic surgeon in your area for advice and treatment.
If you know that you have PIP implants, but have no problems with them, it is advisable to seek a consultation at some stage and perhaps have a scan of your breasts to check on the integrity of the implants. If they show signs of rupture, it is advisable to have the implants removed, even if you do not yet have any of the above. As it has been established that PIP implants contain industrial grade silicone gel instead of a medical grade, you are entitled to ask for the implants to be removed as a precaution, even if they are not ruptured. Alternatively, you may choose to have periodic scans to check on the implants, but you need to consider the cumulative cost of this option in the long term, in addition to the anxiety that it can generate. The non-medical grade of silicone in PIP implants can provoke inflammatory reactions in the breasts and lymph glands in the underarms that can cause pain, discomfort, swelling and anxiety, but there is no evidence that it increases the risk of developing breast cancer.
If you had your surgery under the NHS, contact your GP or your surgeon at the hospital. If you wish to have a consultation at The Westbourne Centre with one of our consultant plastic surgeons, please contact us.
Our Consultant Plastic Surgeon, Fazel Fatah, talks about making the right decision and lessons to be learned regarding PIP implants.
The Westbourne Centre is here to help
The Westbourne Centre would like to offer any patient who has ruptured and unruptured PIP Implants, removal or replacement of their implants at a very minimum cost in recognition of the difficulties they are in and the severe anxiety they may feel. The Westbourne Centre would like to demonstrate that many in the private sector have a high level of patient commitment and always put people before profits.
We have been able to create this opportunity for women with PIP implants only due to the cooperation of a number of Consultant Anaesthetists and a group of Consultant Plastic Surgeons, who are all members of BAAPS and BAPRAS, in response to the plea by the two associations to their members to help these patients in any way they can, even if they were not involved in inserting PIP implants initially.